I received notice by mail yesterday that I passed my ConCert exam. ConCert is the recertification exam for my specialty, Emergency Medicine. Every board-certified ER doc has to do this once every 9 or 10 years to remain boarded. I took the exam on October 20.

The letter came with a mock-up of a press release for me to announce this auspicious event, with spaces to insert my name and hospital, and several paragraphs about the wonders of the American Board of Emergency Medicine. Alert Howard Cosell! Set up an interview with Katie Couric! I read NEJM, The Economist, and Locus, Katie. I believe the earth is over 4 billion years old, but looks younger because it works out and eats a healthy diet.

Although I haven't talked about it on LJ, ConCert has been hanging over my head and causing mild distress for the past year and a half. I've been studying for it daily for the past year, in addition to other continuing medical education required of physicians. I could have put it off for another year, but I elected to take it a year early. Because of, you know, anxiety. If I failed it, I could try again the next year. But if I waited for Year 10, and failed, my butt would be grass. My continued employment would become suddenly doubtful, and to achieve boarded status again would require going through the whole boarding process, with written and oral exams tailored for those who just emerged from med school, not practicing physicians, and which a have a substantially lower pass rate.

I will be spared this. Thanksgiving for me comes two days late this year. I am thankful for having passed the ConCert.

I passed by a comfortable margin. 7% of test-takers fail the exam. I didn't expect to fail, but I found the test harder than expected. There were an alarmingly large number of questions about the more obscure aspects of pediatric viral exanthems and HIV-related esophagitis. But it's hard for the test-taker to tell how he's doing. Every year about 20% of the questions aren't counted. They're just there to test the question, not the test-taker, part of the process of evaluating new questions for possible inclusion on future ConCert test. Still, they make the test unnerving for the test-taker, who at times feels he is wandering through a surreal landscape of Monstrous Questions from Hell, that seem to have no correct answer, or that you would need to have done a fellowship in Pediatric Tropical Medicine to guess correctly. "What? Not another question about Egyptian liver flukes?"

This may be my last re-cert exam. By the time the next one rolls around, my scheme is to be safely retired.

But the best-laid schemes o' mice an 'men gang aft agley, and if the economy doesn't improve, my retirement account may be ganging agley and aglue and aglumph. It has been subjected to the Death of a Thousand Cuts over the past year. I'm not in immediate financial danger, but I'm also not in the condition I want to be to retire. I hope to be in a decade or less, but during the 1930s, and even as recently as the 1970s, the economy didn't cooperate with those sorts of wishes for many years at a stretch. Come 2018, I could still be working, and have to take the ConCert again. A dismal thought.